suture rejection after surger

Posted in the Knee Replacement Forum

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Doris Elliott

Georgetown, KY

#1 Oct 17, 2008
I had bilateral knee replacements on 9/23 and stayed in a rehab hospital afterward. My surgery went well with no complications and PT went well. After a little over two weeks I notice a spot in theincision that was oozing and was covered with yellowish stuff. The doctor looked at it and dug out a suture that he said my body was rejecting. Has this happened to anyone? I am now in a knee immobilizer. The oozing has stopped but no scab has developed. there is no redness and it is not sore. The hole is still there but it appears to be getting smaller. I am taking an antibiotic. I also have RA which compromises my immune system
Winbar

Sarnia, Canada

#2 Apr 6, 2009
Oh yes - suture rejection. I had surgeries resulting in huge abcesses, and prolonged healing. I seemed to be fine - skin closed up and weeks later, blow a hole and an abcess. I had noticed several times during drainage of the wounds, long sutures washing out. Then suddenly I would heal up. My Dr. was baffled. Months after surgery I was blowing holes of abcesses open. Took nearly a year of healing. Few years later and I have surgery again, and again a surgeon uses vincryl ( I think it's spelled right) dissolvable sutures. I heal up nicely and around 2 weeks after surgery a large area bigger than a twoony opens up - the entire layer of skin dissolves away exposing meat below. Sutures are popping out of everywhere, along with inflammation and redness - no pus. My skin dissintegrates away. I suggested - Could I be reacting to the sutures? The Dr. doesn't think so.The Dr. closes the wound using vincryl sutures. He sends a tissue sample for examination. I heal in a week, and another week I break open. I go back, and the tissue sample says foreign body reaction! I'm sensitive to the suture material! and my body rejects it. All I can do now is dressing changes to my wound until the sutures below dissolve away. My skin is tender and painful. Those kind of sutures can never be used on me again.. Hope this helps - it does happen!
grammyb fromNJ

Bridgewater, NJ

#3 Apr 8, 2009
A few weeks post op I felt something catching on my clothes. Upon inspection with a magnifying glass I saw a small filament, like nylon fishing line, coming out my scar. I kept it covered with a bandaid until my next Dr. visit. He said not to worry it would desintegrate in time. He snipped off all he could to make it flush with skin and said leave it uncovered. It took about 3 1/2 months to finally disintegrate and the small hole to close up.
Josephine

Doncaster, UK

#4 Apr 9, 2009
Some people ARE intolerant to synthetic absorbable sutures. The product is called Vicryl and is made by Ethicon (Johnson&Johnson) If you have that reaction you should make sure everyone knows about it should you ever have more surgery. There is an alternative suture called Dexon which is little used these days as Vicryl rather swept the market. But there is a chance you could tolerate that instead.

BoneSmart - the forum for hip/knee patients
http://www.bonesmart.org/public_forum/index.p...
Gunz

Navarre, FL

#5 May 29, 2009
I had knee repl. surgery in late March and had red puffy places at the top and bottom of my incision. They did not go away and here after allthis time they have opened.....the bottom one twice and the top one twice. Also a suture "hole" made a blister and drained blood. They seem to be healing now and I am on a sulpha drug. My surgeon said that they weren't able to bury the knots at top and bottom deeply enough, so they have worked out.(Because I am 74 and have the thin skin of an older woman) The middle place is the spot of another smaller knot and perhaps my body rejected it. Of course, one worries about infection when such upsetting events happen.
Cathy

Fremont, CA

#6 Jul 1, 2010
Hi - My son underwent hernia repair surgery in Apr'09 and developed inflammation. The docs did an abcess drain surgery 3 months later and the wound did not close for 6 months and kept draining. A stitch came out just before this surgery. The docs did another surgery to cut the granulation tissue and stitch up the skin together this time using dissolvable stitches only. During this surgery they found a couple of more permanent stitches all collected in that pocket. But he developed inflammation again and we kept doing warm compress to open in up and coeterized to close it back and fort. After about 10 months it finally closed on its own but now after 6 months of staying closed there is a pimple again and we had to open it up using warm compress. Docs suspect another stitches may be coming out. My son is just 4 yrs old! Has anyone seen this?
Winbar - your story sounds similar - prolonged healing etc. How long did it finally take to heal completely?
thanks!
akamom

Orlando, FL

#7 Aug 2, 2010
I am now experiencing the same thing! I am 4 weeks post abdominal surgery and I have 4 areas of suture spitting. 3 of them are not problematic...meaning I barely felt anything going on and only noticed something when my clothes would rub and catch on the area, However, one area has been very painful since about 10 days post op. I told the doc about it at my visit at that time and they said it was a suture coming out and it would work its way out on its own and I could clip it off at the skin level.I was advised DO NOT PULL IT OUT on my own. So, home I went and dealt another 3 weeks of it and I yesterday O noticed the hole is getting bigger instead of smaller! So today.....Off to the doctors office I went and they dug around in there and clipped and cleaned it all out. I am now put back on antibiotics again and I am not a happy camper to be 4 weeks post op and still dealing with issues. I was hoping to be healed by now. I don't know in the long run how this will effect the appearance of the scar and I am hoping it will heal up nicely...but dissapointed in the delay of healing just the same. I am really sorry to read about the others that have had to deal with this...and I totally understand what you are going thru....never heard of this before this happened to me and the weird thing is I have had multiple surgeries over the years and this has never happened to me in the past. Guess I shoudl find out what kids of sutures were used in this case and avoid them if I ever have surgery again in the future!
MNEUHAU

Perrysville, OH

#8 Oct 14, 2010
I ALways have this problem following surgery. I had ACL reconstruction about 9 weeks ago, and am still having problems. So far, six sutures have come out of my knee. It will begin to heal, then another rough spot will form, and out pops a suture. It is really annoying, but eventually it will get better. This is my third surgery, and it has happened every time.
jdettman

Rochester, NY

#9 Dec 29, 2010
yes! i am now experiencing suture problems. I had
abdominal surgery for an obstruction, 5 yrs ago!
january of 2010 and july and now dec 29th, i get painfull areas @ the old incision site with a lump, no redness. i went too the Drs. he opened me up and found a proleen non-disolvable suture each time. each
time i have too pack the opened wound for a month.
is there an end too this problem?
Michele

Escondido, CA

#10 Feb 3, 2011
I had my left knee replaced 4 weeks ago. I have an allergy to nickle. The staples contained nickle and had to come out 10 days after surgery. I forgot about my allergy until I saw the red bubbling sores on my knee. I had a previous reaction to hardware in my ankle and it had to be removed because of this. I had begun to develop red bubbly sores on my ears where they were pierced. A bone scan revealed a major problem and I had to have the hardware removed. It was never documented in my chart and I forgot about it. Stupid on my part, to say the least. I saw my surgeon for the first time today 4 weeks post op. He tells me the implant has nickle in it but there is nothing to worry about. He seems to be downplaying things somewhat. He told me they all have nickle in them and if he takes it out all he will be able to do is fuse my knee straight. This doesn't really reassure me of much. I want to get more answers but don't know where to go. Can anyone suggest a place for me to start?
Karen

West Monroe, NY

#11 Feb 5, 2011
I had a complete abdominal hysterectomy over four months ago. I have had my absesses opened and cleaned three times with the spitting of stitches. My initial incision is healed up (for now)but I still experience a lot of pain in my abdomen near the incision sight (feels like severe bruising) and I have red blotches that feel like a burn that appear. They fade with the use of antibiotics but I get little relief at this point. I am now using lidocaine patches for the pain. I had surgery to feel better! This is awful!
JAJ

Winnipeg, Canada

#12 Apr 20, 2011
I had a vericose vein surgury October 2009. Since then my body has rejected about 20 dissolvable stiches. My wound closed for 2 weeks after what I thought was the last soucher to come out yet it just opened up again. Dr's don't know what to do with me and are stumped.
berry

Carlsbad, CA

#13 May 10, 2011
My daughter had tarsal coalition (ankle) surgery and is now 7 weeks post op. The wound still has not closed. It starts to scab then drains and oozes, then repeats the cycle. This weekend 2 stitches "spit" out of her incision. Wondering if soaking in epsom salts might be a good idea to help work them out. Obviously the body is seeing them as "foreign objects". Also wondering if Johnson and Johnson has familiarity with this issue.
Sheila

Woodinville, WA

#14 Jun 14, 2011
My 16 year old daughter had microfracture surgery on both knees in October to help promote healing of chronic tendonitis (jumper's knee). Healing appeared to be going fine for the first 2 weeks then the sutures just started to reopen and turned red and puss started oozing out. Her surgeon said it was an allergic reaction to Vicryl, a chemical used on the internal stitches that was supposed to dissolve into her body. He downplayed the severity of this allergic reaction and made it sound like her body would fight it out fairly quickly, and that this type of reaction was highly unusual. We are now in June, 8 months after the surgery and her knees just finally closed up. The scars are disfigured, wide and raised up. They look nothing like what he described that the outcome would be. There is a huge amount of scar tissue developed as well. She still has severe pain in both knees which now they are not sure whether to attribute to the underlying tendonitis condition not being improved or the raging vicryl infection, or both. Now that the scabs have finally closed up (they reopened about 3 or 4 different times over the months) they are suggesting another surgery to "clean out the foreign body and get rid of the infection." Then we can attempt to treat the tendonitis again. Meanwhile, my daughter has missed an entire year of her life already, being unable to do all the things she used to love: volleyball, swimming, snowboarding and even the simple things like school dances and wearing skirts to school (she is self conscious about the horrible scarring). All because of vicryl. Reading these posts, I have trouble believing that surgeons do not know the risks of using this type of harmful closure material. And I think they take the seriousness of their decisions far too lightly. Had I known then what I know now, I would never even have considered surgery for her. We are in a FAR worse place than we were a year ago when we started on this joruney.
JoyD

United States

#15 Aug 6, 2011
I, too, always have my vicryl stitches come out years later. Most work there way out within 3 years but I have one coming out from a scar from surgery I had 8 years ago!! I work in surgery and I asked one of the surgeons and he said it's not uncommon, that my body rejects vicryl stitches and to ask for another kind when and if I have surgery again. Most of my other stitches have just come to the surface and I popped them out like a zit. But the one I have now that's coming to the surface is on my shoulder from a shoulder mass removal 8 years ago and it has been taking over a month to surface. It is hard and swollen and painful under that little spot. Maybe the skin's a little thicker than the other areas I had vicryl stitches come out before (abdomen and breast). And that's why it's taking so long. Weird.
charley Tucson az

Tucson, AZ

#16 Aug 23, 2011
Where you can you get legal help for severe Vicryl reactions?
It seems like just Panacryl is on the table now .
I have had a Vet tell me he will no longer use Vicryl in small animals.
3 surgeries later!
Sue

Indio, CA

#17 Nov 25, 2011
So, does one NOT try to pull a stitch out if it's just pinching and below the surface? I should not try to pull it through?

I have one just barely poking me, 2 inches from my hip incision and it is very tiny and I can barely see it let alone try to pull it, but do I just leave it alone for safety sake?

I see my doctor for a follow-up (8 weeks post-op) in 2 weeks.
Winnie

Grove City, OH

#18 Dec 16, 2011
Sue wrote:
So, does one NOT try to pull a stitch out if it's just pinching and below the surface? I should not try to pull it through?
I have one just barely poking me, 2 inches from my hip incision and it is very tiny and I can barely see it let alone try to pull it, but do I just leave it alone for safety sake?
I see my doctor for a follow-up (8 weeks post-op) in 2 weeks.
No don't pull it!!! If your surgeon does that's one thing. There are many layers of deep sutures holding many tissue layers in place. Most of the sutures are connected...meaning if you yank on it, you unravel what is holding your surgery wound together. Not unlike unraveling a seam on a shirt. Leave them be!
Junice

Baytown, TX

#19 Jan 3, 2012
akamom wrote:
I am now experiencing the same thing! I am 4 weeks post abdominal surgery and I have 4 areas of suture spitting. 3 of them are not problematic...meaning I barely felt anything going on and only noticed something when my clothes would rub and catch on the area, However, one area has been very painful since about 10 days post op. I told the doc about it at my visit at that time and they said it was a suture coming out and it would work its way out on its own and I could clip it off at the skin level.I was advised DO NOT PULL IT OUT on my own. So, home I went and dealt another 3 weeks of it and I yesterday O noticed the hole is getting bigger instead of smaller! So today.....Off to the doctors office I went and they dug around in there and clipped and cleaned it all out. I am now put back on antibiotics again and I am not a happy camper to be 4 weeks post op and still dealing with issues. I was hoping to be healed by now. I don't know in the long run how this will effect the appearance of the scar and I am hoping it will heal up nicely...but dissapointed in the delay of healing just the same. I am really sorry to read about the others that have had to deal with this...and I totally understand what you are going thru....never heard of this before this happened to me and the weird thing is I have had multiple surgeries over the years and this has never happened to me in the past. Guess I shoudl find out what kids of sutures were used in this case and avoid them if I ever have surgery again in the future!
I had abdominal surgery 10 months ago and my belly button was constantly draining. After 10months the dr relized my body was rejecting the sutures and I have to be cut wide open in a week to take the rest of the sutures out.
ewattsjt

Avon, IN

#20 Jan 9, 2012
Vicryl suture rejection while not common place, it does sometimes occur. The physician may refer to it as "spitting suture, foreign body rejection, or suture rejection."
While I have not had knee surgery, I have had several surgeries in which my body rejected the Vicryl suture in the last three cases (fatty tumor removed on chest side, inguinal herinias and tendon repair on finger). These surgeries occured a couple years apart and all had similar rejections. This alone would suggest a rejection rather than a contaminated suture (infection).

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